Naoyuki Nakao

Naoyuki Nakao
Wakayama Medical University · Department of Neurological Surgery

About

173
Publications
5,306
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3,425
Citations
Citations since 2017
51 Research Items
703 Citations
2017201820192020202120222023050100150
2017201820192020202120222023050100150
2017201820192020202120222023050100150
2017201820192020202120222023050100150

Publications

Publications (173)
Article
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Lymphomatoid granulomatosis (LYG) is a rare lymphoproliferative disorder (LPD). The optimal management strategy of methotrexate (MTX) related-LPD with central nervous system (CNS) involvement and histological features of LYG remains unclear. We herein report a case of grade 2-3 LYG in a rheumatoid arthritis patient, in which an intracranial mass ac...
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Introduction The NovoTTF-100A System (NovoTTF™ Therapy, Optune®, Novocure Inc.) is approved for use as a combination therapy with adjuvant temozolomide after postoperative chemo-radiation for newly diagnosed supratentorial glioblastoma (GBM). In our experience, dermatologic adverse events (dAEs) due to the continuous contact between the array and t...
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Background and Purpose Diffuse midline glioma(DMG),H3K27 alterd (WHO 2021, CNS grade 4) is a type of tumor that mainly develops in the CNS's median. However, owing to its rarity, few comprehensive reports have been published. This report conducted a retrospective study on H3p.K27M mutation cases via the Kansai Molecular Diagnosis Network for CNS tu...
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To assess the clinicopathological features and prognostic factors of pediatric intracranial ependymomas and to explore the current diagnostic practice, we analyzed clinical data from the Brain Tumor Registry of Japan (BTRJ). Data of fifty children under 18 years of age diagnosed with intracranial ependymoma were extracted from the BTRJ database. Ca...
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We report the case of a middle-aged woman with obesity who presented with otitis media with effusion and rhinorrhea. The diagnosis was a spontaneous middle cranial fossa encephalocele. Cerebrospinal fluid leak repair was planned to prevent meningoencephalitis. We resected the encephalocele and repaired the defect of the right pyramidal bone using t...
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Background Small-cell carcinoma of the urinary bladder (SCCB) accounts for 1% of all bladder tumors. We present a rare case of hemorrhagic metastatic brain tumor from SCCB diagnosed by navigation-guided endoscopic biopsy. Case Description A 76-year-old man presented with sudden onset of aphasia and right hemiplegia from 3 weeks previously. He had...
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Introduction: In glioma patients, epilepsy not infrequently occurred and anti-epileptic drugs (AEDs) are commonly used. In this study, we revealed the real-world data on clinical practice of glioma-related epilepsy in Wakayama Medical University Hospital (WMUH). Methods. We collected clinical and molecular data of glioma patients operated at WMUH f...
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We report a rare case of adult pial arteriovenous fistula (PAVF) treated with preoperative embolization and surgical excision. A 26-year-old man presented with sudden headache and vomiting. CT demonstrated a subcortical hemorrhage in the left temporal lobe. Cerebral angiograms revealed a PAVF. He was treated with endovascular embolization by n-buty...
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Background/aim: High-grade gliomas have a poor prognosis despite standard treatment. The aim of the study was to identify new prognostic factors to select patients who need more intense treatment. Patients and methods: Forty-three consecutive patients underwent surgery plus chemoradiotherapy for pathologically diagnosed high-grade gliomas (grade...
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We explored regional functional connectivity alterations in intractable focal epilepsy brains using resting-state functional MRI. Distributions of the network parameters (corresponding to degree and eigenvector centrality) measured at each brain region for all 25 patients were significantly different from age- and sex-matched control data that were...
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Objective: Early recanalization of acute stroke caused by large vessel occlusion (LVO) may improve high signal intensity (HSI) on diffusion-weighted imaging (DWI). In this study, we investigated whether subtraction of reversible ischemic lesions (RIL) from the HSI lesions on DWI improves the diagnostic accuracy for the ischemic core. Methods: A tot...
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The superior cerebellar artery (SCA) is the most frequent offending vessel in trigeminal neuralgia. This study aims to elucidate the patterns of the SCA running in 34 patients with typical trigeminal neuralgia using three-dimensional computer graphics. The SCA which runs in the medial aspect of the trigeminal nerve compressed predominantly the root...
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Background: Diffuse midline glioma (DMG) is a fatal childhood brain tumor and the majority of patients die within 2 years after initial diagnosis. Factors that contribute to the dismal prognosis of these patients include the infiltrative nature and anatomic location in an eloquent area of the brain, which precludes total surgical resection, and the...
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BACKGROUND: Geriatric neuro-oncology is an important research field, because the elderly patients is growing at a very rapid rate. This study investigates molecular features and their prognostic effects in the elderly glioblastomas (GBM). METHODS: We collected adult cases diagnosed with IDH-wildtype GBM and enrolled in Kansai Molecular Diagnosis Ne...
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Introduction: Mismatch repair (MMR) genes are associated with the MMR mechanism that corrects DNA polymerase misincorporation errors. We analyzed the aggressive pituitary adenomas (PAs) associated with Lynch syndrome due to germline mutation in the MMR gene. Reduced expression of MMR genes mutS homologs 6/2 (MSH6/2) directly promotes PA growth (1,...
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Aging is a known negative prognostic factor in glioblastomas (GBM). Whether particular genetic backgrounds are a factor in poor outcomes of elderly patients with GBM warrants investigation. We aim to elucidate any differences between older and younger adult patients with IDH-wildtype GBM regarding both molecular characteristics and clinical outcome...
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Mismatch repair genes mutS homologs 6/2 (MSH6/2) expressions are involved in tumor growth and programmed cell death 1 ligand 1 (PD-L1) expression in tumor immunity, but the direct association with pituitary adenomas (PAs) is not well understood. We aimed to clarify the effects of MSH6/2 and PD-L1 expression on tumor proliferation and invasiveness i...
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Objective: The efficacy and safety of aspiration thrombectomy using Penumbra catheter with acute large vessel occlusion in the anterior circulation have been reported in previous studies. In some cases, the carotid siphon (CS) is elongated, and with this anatomy, especially where there is bifurcation of the ophthalmic artery (OA), navigation of Pen...
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Aphasic status epilepticus (SE) is a clinical entity of SE, but it has not been well recognized. We report a 43-year-old female with a chronic drug-resistant epilepsy with aphasic SE, treated by resective surgery. The patient showed long-lasting weekly hypokinesia, slow verbal response, and dysphasia, which were diagnosed as symptoms of aphasic SE....
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Introduction : Neural tube defects are usually observed at the brain and lumbosacral levels. We report a case of adult cervical spina bifida occulta that led to myelopathy. Case presentation : A 66-year-old woman presented with 5-month history of pain from the right occipital region to the upper limb, dullness of the bilateral upper limbs, numbness...
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Cervical foraminal canal stenosis is a common disease, but any relationships between the measurement values of cervical foraminal canals and clinical symptoms have yet to be explored. We aim to determine a numerical cutoff point of cervical foraminal bony canal size that does not lead to radiculopathy so as to establish criteria for the surgical in...
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We attempted to establish a magnetic resonance imaging (MRI)-based radiomic model for stratifying prognostic subgroups of newly diagnosed glioblastoma (GBM) patients and predicting O (6)-methylguanine-DNA methyltransferase promotor methylation (pMGMT-met) status of the tumor. Preoperative MRI scans from 201 newly diagnosed GBM patients were include...
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A 63-year-old man was admitted in our hospital with the chief complaint of upper limb numbness 3 years after undergoing spinous process-splitting laminoplasty (C3–C7) in another hospital. The hydroxyapatite spacers used for the laminoplasty had dislocated, resulting sensory disorders of the upper extremities. Additionally, loosened hydroxyapatite i...
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Objective: To analyze why women quit full-time employment as neurosurgeons and to discuss the conditions required for their reinstatement. Methods: We asked 94 core hospitals providing training programs in the board certification system adopted by the Japan Neurosurgical Society to indicate the total number and present status of women in their d...
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In the anterior skull base surgery, deteriorations of the olfactory function due to the nerve damage can occur under several conditions of surgical procedures. The surgical procedures include : (1) preservation of the olfactory nerve in cases of bilateral subfrontal, basal interhemispheric, and transbasal approaches, and (2) dissection of the olfac...
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Objective: This study evaluated the efficacy of middle meningeal artery (MMA) embolization for organized chronic subdural hematoma (OCSDH). Methods: Between 2013 and 2017 at our institution, 11 consecutive patients with 14 OCSDH lesions required MMA embolization, accounting for 4.5% of the 314 patients treated for chronic subdural hematoma (CSDH) i...
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Purpose: Carotid artery stenting (CAS) reduces the risk of ischemic stroke in patients with carotid artery stenosis, although recent randomized trials showed an increase in periprocedural stroke risk in elderly patients undergoing CAS. Recently, the safety and efficacy of tailored-CAS was reported. We retrospectively compared the clinical results o...
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O-6-methylguanine-DNA methyltransferase promotor methylation (pMGMT-met) is identified as a favorable prognostic factor for glioblastoma (GBM) and patients with GBM containing pMGMT-met benefit from temozolomide. On the other hand, radiomic analysis that rely on quantitative texture feature of radiological images has rapidly emerged in the field of...
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Introduction: This study investigates the current state of clinical practice and molecular analysis for elderly patients with diffuse gliomas and aims to elucidate treatment outcomes and prognostic factors of patients with glioblastomas. Methods: We collected elderly cases (≥ 70 years) diagnosed with primary diffuse gliomas and enrolled in Kansa...
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Objective: We describe a case of de novo dural arteriovenous fistula (dAVF) developed after bilateral neck clipping for middle cerebral artery (MCA) aneurysms, treated with transarterial embolization (TAE) using liquid materials. Case Presentation: A 60-year-old man underwent neck clipping for a right ruptured MCA aneurysm, and a left unruptured MC...
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Superficial siderosis (SS) of the central nervous system is a rare disease caused by chronic or repeated hemorrhages in the subarachnoid space. Closure of dural defects is an effective therapy for SS. Conventional magnetic resonance imaging (MRI), however, cannot sufficiently detect dural tears. To better detect these defects, we analyzed the clini...
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Cerebral venous sinus thrombosis is sometimes fatal. We describe a case of sinus thrombosis in a 43-year-old woman presenting with generalized seizure, delirium, and a 2 week history of headache and nausea. The patient underwent mechanical thrombectomy using a novel combined approach, in which a Shouryu HR balloon catheter (Kaneka) was anchored in...
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Cerebral venous sinus thrombosis is sometimes fatal. We describe a case of sinus thrombosis in a 43-year-old woman presenting with generalized seizure, delirium, and a 2 week history of headache and nausea. The patient underwent mechanical thrombectomy using a novel combined approach, in which a Shouryu HR balloon catheter (Kaneka) was anchored in...
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We report a case of transverse sinus-sigmoid sinus dural arteriovenous fistula(T-S dAVF)with venous flow congestion, which was accompanied by sigmoid sinus stenosis and treated with percutaneous transluminal sinus stenting. A 76-year-old woman presented with dementia and disturbance of consciousness. Magnetic resonance imaging(MRI)on admission reve...
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Tentorial dural arteriovenous fistula(dAVF)is classified as Cognard 4 with a high risk of aggressive feature, such as intracranial hemorrhage, venous infarction, and intracranial hypertension. We report a rare case presenting with ocular symptoms caused by tentorial dAVF. A 59-year-old man presented with progressive chemosis and exophthalmos of his...
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Context The mechanisms of pituitary adenoma (PA) pathogenesis and proliferation remain largely unknown. Objectives To evaluate the direct association between PA proliferation and expression of mismatch repair (MMR) genes and proteins, and to clarify the role of MMR genes in the molecular mechanism of PA proliferation. Experimental Design We perfo...
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Objective: Plaque protrusion is one of the current problems with carotid artery stenting (CAS) for carotid artery stenosis, and it may induce delayed postprocedural cerebral infarction. In this study, we evaluate the possibility of using three-dimensional rotational angiography (3DRA) to examine the stent lumen during CAS. Methods: First, as a basi...
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Objective: A rare complication, a carotid-cavernous fistula (CCF), that developed during stent retriever thrombectomy for acute ischemic stroke is reported. Case Presentation: A 67-year-old woman with consciousness disturbance and left hemiparesis underwent stent retriever thrombectomy for acute right M1 proximal occlusion of the middle cerebral ar...
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Objective: A case of folding deformation of a PROTÉGÉ RX (PROTÉGÉ; eV3 Covidien, Irvine, CA, USA) stent during carotid artery stenting (CAS) with distal filter protection is reported. Folding deformation complicated retrieval of the filter device. Case Presentation: A 67-year-old man was diagnosed with left asymptomatic cervical internal carotid ar...
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To understand how information from different cortical areas is integrated and processed through the cortico-basal ganglia pathways, we used optogenetics to systematically stimulate the sensorimotor cortex and examined basal ganglia activity. We utilized Thy1-ChR2-YFP transgenic mice, in which channelrhodopsin 2 is robustly expressed in layer V pyra...
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Purpose: The treatment outcomes of subarachnoid hemorrhage in patients aged >80 years are considered poor. We analyzed the clinical results of endovascular coil embolization for ruptured cerebral aneurysm in patients over 80 years old. Materials and Methods: Between 2000 and 2015, 43 patients over 80 years old were treated with coil embolization as...
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We report a case of tentorial dural arteriovenous fistula (dAVF) treated with transarterial and transvenous embolization using n-butyl-2-cyanoacrylate (NBCA). A 70-year-old man presented with dysarthria and trunk ataxia. Computed tomography (CT) on admission revealed right cerebellar hemorrhage. Right external carotid angiography demonstrated a ten...
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The mechanism of pituitary tumorigenesis remains largely unknown. Lynch syndrome is an autosomal, dominantly inherited syndrome caused by a defective mismatch repair (MMR) mechanism involved in the development of various tumors at an early age. In this case study, we showed the occurrence of pituitary tumors associated with Lynch syndrome for the f...
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Osteoblastomas are benign bone tumors that produce prostaglandin and promote inflammation. The aim of the present study was to describe the clinical and radiological characteristics of a pediatric osteoblastoma case over an 8-month postoperative follow-up. The case involved an 11-year-old female patient with normal somatic development, presenting w...
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BACKGROUND AND IMPORTANCE: Stent-assisted coil embolization has been established as a treatment option for wide-necked or complex aneurysms. However, concerns have been raised about the incidence of thromboembolic complications, which is higher for coil embolization without stent assistance. Long-term antiplatelet therapy is necessary to prevent ac...
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Objective: Optical coherence tomography (OCT) has recently been applied for the characterization of carotid plaques, but few studies have compared OCT findings with findings from histopathologic examination of carotid plaques. We consider the accuracy, problems, and limitation of OCT findings by comparing OCT findings of carotid artery stenosis and...
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Background Our initial experience using the two-stage aspiration technique (TSAT) with proximal flow arrest by a balloon guiding catheter is presented. In TSAT, aspiration is applied with the 5MAX ACE and also with the 3MAX catheter with a Penumbra aspiration pump, while arresting proximal flow by balloon inflation. Methods In patients treated wit...
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Background: Various definitions of pseudo-occlusion and clinical outcomes after various treatments have been reported, but reports discussing the stenotic characteristics of pseudo-occlusion are rare. Objective: To analyze the angiographic characteristics of pseudo-occlusion of the internal carotid artery (ICA) before and after carotid artery st...
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To investigate the working conditions of female neurosurgeons in Japan, two surveys were conducted by The Japan Neurosurgical Society: one involving female neurosurgeons themselves and the other involving the chiefs of neurosurgical departments. The responses were received from 224 (43.8%) female neurosurgeons and 496 (61.2%) departmental chiefs. A...
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Recently, endovascular therapy (EVT) for acute ischemic stroke has been developed to enhance early recanalization in patients who do not respond to intravenous recombinant tissue plasminogen activator (rt-PA). However, the efficacy of EVT remains uncertain. We compared clinical outcomes in patients treated with intravenous rt-PA alone (t-PA group;...
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Carmustine wafers, which are locally delivered chemotherapy in the form of biodegradable implants, confer a survival benefit to patients with glioblastoma (GB) following surgical resection. While the adverse events of this method, including gas retention and perifocal edema, have been extensively investigated, the immediate efficacy of the implant...
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Objective: Skull base meningiomas occasionally show aggressive growth particularly when they recur. Recurrent cranial base meningiomas extending widely into skull base and craniofacial structures are one of the most challenging tumors to treat surgically. We reviewed our experience of treatment in a series of patients with those aggressive meningio...
Article
This video demonstrates surgical techniques of the occipital transtentorial approach to a pineal region tumor without using a fixed brain retractor, which may cause functional impairment or even tissue injury to the occipital visual cortex. There are several ways to facilitate retractorless surgery through this approach. A lateral-semiprone positio...
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Various types of bed-exit sensor systems are usually used to prevent falls from a bed at a ward in the hospitals. However, the existing sensors are not too useful enough to be satisfied by nursing staffs. We developed a new bed-exit sensor system, called “Watching Sensor”, using a three-dimensional range image sensor. It is not necessary to equip a...
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A 62-year-old man presented to the emergency room with mild dysarthria and right motor weakness. The patient was diagnosed with aortic dissection (DeBakey type III) in the cardiovascular department of our institution two years ago and was then treated with left carotid-bilateral subclavian bypass with collagen-seated Dacron graft followed by thorac...
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Purpose: Endovascular coil embolization for very small aneurysms (≤3mm) is considered to be technically challenging because of technical difficulties and high complication rates. We aimed to evaluate the results of endovascular coil embolization for very small aneurysms.Materials and Methods: Between 1998 and 2012, 48 very small aneurysms in 45 pat...
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The authors report an unusual case of a dural arteriovenous fistula (dAVF) draining only to the diploic vein and causing intracerebral hemorrhage. A 62-year-old woman presented with disturbance of consciousness and left hemiparesis. Brain CT scanning on admission showed a right frontal subcortical hemorrhage. Digital subtraction angiography reveale...
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We report a case of external carotid artery (ECA) angioplasty and stenting followed by superficial temporal artery (STA) to middle cerebral artery (MCA) bypass for internal carotid artery occlusion with ipsilateral ECA stenosis. A 63-year-old patient presented with moderate left hemiparesis, and imaging studies revealed cerebral infarction at the r...
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Objective: We report a case of cavernous sinus dural arteriovenous fistula (CdAVF) successfully treated using a triple coaxial catheter system for a transfemoral superior ophthalmic vein (SOV) approach via the facial vein.Case presentation: A 50-year-old woman presented with left chemosis and exophthalmos. Angiograms showed the left CdAVF draining...
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Objectives Radiation-induced aneurysm is a rare complication for head and neck tumors. Only seven cases of an aneurysm after stereotactic radiosurgery and/or stereotactic radiotherapy (SRT) have been described. We report two patients with a ruptured internal carotid artery (ICA) aneurysm presenting with catastrophic epistaxis after repeated SRT for...
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Endoscopic evacuation of intracerebral hemorrhage has seen significant advances in surgical instruments and techniques. The advantage is a less invasive surgery for a short operation time compared with craniotomy surgery. On the other hand, the main disadvantage is uncertain hemostasis and the potential for postoperative bleeding. To overcome this...
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The transpetrosal approach, involving resection of the petrous bone to various degrees, provides different levels of access to the petroclival region. According to the area and degree of petrous bone removal, the transpetrosal approach can roughly be divided into an anterior, posterior and their combined approach. Factors considered to be important...
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Temozolomide (TMZ), a DNA methylating agent, is widely used in the adjuvant treatment of malignant gliomas. O6-methylguanine-DNA methyltranferase (MGMT), a DNA repair enzyme, is frequently discussed as the main factor that limits the efficacy of TMZ. Zoledronic acid (ZOL), which is clinically applied to treat cancer-induced bone diseases, appears t...
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The histogenesis and pathogenesis of xanthogranuloma remain unknown. We present a case of sellar xanthogranuloma that has developed from Rathke's cleft cyst during a period of 3 years as evidence by on serial magnetic resonance imaging (MRI) studies. A 9-year-old boy was admitted to our hospital, presenting with headache and general malaise. Endocr...
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Tardive dystonia (TD) is a disabling movement disorder associated with exposure to neuroleptic drugs. It is usually irreversible and its medical treatment is notoriously difficult. We performed bilateral deep brain stimulation (DBS) of the globus pallidus internus (GPi) to treat a severe case of TD. A 49-year-old woman, who was administered antidep...
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Adenoid cystic carcinoma is a malignant epithelial tumor derived from salivary glands and tends to invade the surrounding structures including nervous system. We present a case of adenoid cystic carcinoma with intracranial extension and propose a novel molecular mechanism of adenoid cystic carcinoma metastasis. A 29-year-old Japanese male presented...
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Identifying the dural tear point is not easy in cases of cerebrospinal fluid leakage, and specific examination is needed for identifying and treating such dural tears. In this study, the leakage point was estimated using standard magnetic resonance imaging (MRI, T2* reverse imaging). This technique avoids the use of drugs and lumbar puncture. It is...
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Hemodynamic insults - high wall shear stress (WSS) combined with high positive WSS gradient (WSSG) - have been proposed to link to cerebral aneurysm initiation. We report four cases of aneurysms with proximal stenosis including one de novo aneurysm, which might be associated with hemodynamic insults caused by the proximal stenosis. In four clinical...
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Background Aneurysm formation after stereotactic irradiation of skull base tumors is rare. The formation and rupture of an internal carotid artery (ICA) aneurysm in a patient with skull base Ewing sarcoma/primitive neuroectodermal tumor (PNET), who underwent surgery followed by multiple courses of intensity-modulated radiation therapy (IMRT) and ch...
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We report a patient's case of slow progressive in-stent restenosis 10 years after bare-metal stent implantation to his carotid artery. We treated the patient with an additional stent placement under a distal filter protection device. Optical coherence tomographic assessment and plaque histology during the carotid artery stenting (CAS) revealed athe...
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A 40-year-old woman was admitted to our hospital presenting as proptosis of the left eye. Computed tomography showed hyperostosis of supero-lateral wall of orbit, sphenoid ridge and temporal squama bone. There was no intracranial mass. On angiography, the thickened bone presented with a remarkable tumor stain fed by the middle menigeal artery. Foll...